The results of the comparative study of nadolol, propranolol, prazosin and hydrochlorothiazide in patients with arterial hypertension in a 12-month stepped-plan treatment (cooperative research) . The Working Group of the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension. I. The research protocol and results of monotherapy
Metelitsa, V.I.; Filatova, N.P.
Terapevticheskii Arkhiv 63(8): 30-34
1991
ISSN/ISBN: 0040-3660 PMID: 1792612 Document Number: 381933
The paper concerns a cooperative open study with participation of 10 centers of the USSR. After receiving placebo 419 men aged 30-59 years suffering from arterial hypertension (diastolic arterial pressure in the sitting position greater than or equal to 95 mm Hg) were given antihypertensive drugs after randomization. The treatment was provided in accordance with a stepped scheme and was started from monotherapy with the beta-adrenoblockers nadolol or propranolol (PP), or with the indirect vasodilator prazosin (PS) or the diuretic. If monotherapy failed, the patients were administered combinations of the indicated drugs. The treatment lasted one year, with a monthly control being exercised. 356 patients completed the studies. Of these, 131 patients (36.8%) had received monotherapy toward the end of the year. During the entire year, monotherapy was provided to 48.9% of the patients who started treatment from nadolol and completed the studies, to 34.1% who started treatment from PP, to 35.5% who started treatment from PS, and only to 14.4% of the patients who started treatment from the diuretic. Comparison of the patients' group given the diuretic with all the remaining groups demonstrate the difference to be significant. By the end of the treatment with nadolol, PP and PS, the diastolic arterial pressure reduced 10-11%, whereas toward the end of monotherapy with the diuretic, it dropped 6%, with the difference being significant. In patients on monotherapy, the negative chronotropic effect of nadolol exceeded that in patients given PP. Nadolol is an effective long-acting beta-blocker. By the intensity of the antihypertensive effect the drug is not inferior to PP or PS and compares very favourably with the diuretic.